Pregnancy in relapsing polychondritis: twenty-five pregnancies in eleven patients

Arthritis Rheum. 1997 Jul;40(7):1245-9. doi: 10.1002/1529-0131(199707)40:7<1245::AID-ART8>3.0.CO;2-#.

Abstract

Objective: To determine maternal and fetal outcome in pregnant women with relapsing polychondritis (RP).

Methods: Retrospective review of 11 records selected from among those of 116 female RP (Michet's criteria) patients.

Results: In these 11 women, 25 pregnancies occurred after or concomitantly with the onset of RP. The mean (+/- SD) age at RP onset was 25 +/- 5 years (range 15-31). Therapeutic abortion was performed in 1 woman because of ongoing cyclophosphamide treatment. Disease flare occurred in 7 of 24 pregnancies, requiring treatment modification in 2 cases. RP was considered stable in 16 and asymptomatic in 1 of the 24. Treatment of RP was with nonsteroidal antiinflammatory drugs (2 of 24), steroids (13 of 24), dapsone (7 of 24), or plasma exchanges (1 of 24); no treatment was given in 8 of the 24 pregnancies. In 14 pregnancies, the course was uneventful. Ten pregnancies were complicated by ectopic nidation (n = 3), spontaneous abortion (n = 3), premature birth (n = 3), and premature rupture of membranes (n = 1). Eighteen normal children were born.

Conclusion: Pregnancy does not seem to modify the course of RP. Successful pregnancies may be achieved in women with RP. No RP was observed in the neonates.

MeSH terms

  • Abortion, Spontaneous / etiology
  • Abortion, Therapeutic
  • Adolescent
  • Adult
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Antirheumatic Agents / therapeutic use
  • Cyclophosphamide / therapeutic use
  • Dapsone / therapeutic use
  • Female
  • Fetal Membranes, Premature Rupture / etiology
  • Humans
  • Obstetric Labor, Premature / etiology
  • Plasma Exchange
  • Polychondritis, Relapsing / physiopathology*
  • Polychondritis, Relapsing / therapy
  • Pregnancy
  • Pregnancy Complications / physiopathology*
  • Pregnancy Complications / therapy
  • Pregnancy Outcome*
  • Retrospective Studies
  • Steroids / therapeutic use

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antirheumatic Agents
  • Steroids
  • Cyclophosphamide
  • Dapsone